Observations on Abortion / Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating it

by John Burns

When abortion is threatened, the process is very apt to go on to completion; and it is only by interposing, before it is fairly begun, that we can be successful in preventing it, for whenever the muscular action is established, nothing, I believe, can check the process. As this is often the case before we are called, or, as in many instances it depends on the action of gestation being stopped by causes, whose action could not be ascertained until the effect be produced, we shall oftener fail than succeed in preventing expulsion.

This is greatly owing to our not being called until abortion has begun; whereas, had we been applied to upon the first unusual feeling, it might have been prevented. What I wish then particularly to inculcate is, that no time be lost in giving notice of any ground of alarm, and that the most prompt measures be had recourse to in the very beginning, for when uterine contraction has commenced, then all that we can do is to conduct the patient safely thro’ a confinement, which the power of medicine cannot prevent.

The case of threatened abortion, in which we most frequently succeed, is that arising from slipping of the foot, or similar causes, producing a slight separation, because here the hemorrhage immediately gives alarm, and we are called before the action of gestation be much affected.

Could we impress upon our patients the necessity of equal attention to other preceding symptoms and circumstances, we might succeed in many cases where we fail from a delay, occasioned by their not understanding that an abortion can only be prevented by interfering before it begins, but that, when sensible signs of it appear, the mischief has proceeded too far to be checked.

Of the Prevention and Treatment of Abortion.

In considering the treatment, I shall first of all notice the most likely method of preventing abortion in those who are subject to it; next, the best means of checking it, when it is immediately threatened; and, lastly, the proper method of conducting the woman through it, when it cannot be avoided.

The means to be followed in preventing what may be called habitual miscarriage, must depend on the cause supposed to give rise to it. It will, therefore, be necessary to attend to the history of former abortions; to the usual habitudes and constitution of the woman; and to her condition when she becomes pregnant.

In many instances a plethoric disposition, indicated by a pretty full habit, and copious menstruation, will be found to give rise to it. In these cases; we shall find it of advantage to restrict the patient almost entirely to a vegetable diet, and, at the same time, make her use considerable and regular exercise.

The sleep should be abridged in quantity, and taken not on a bed of down, but on a firm mattress, at the same time that we prevent the accumulation of too much heat about the body. The bowels ought to be kept open, or rather loose, which may be effected by drinking Cheltenham water: and this can be artificially prepared, if necessary.

There is, in plethoric habits, a weakness of many, if not all, of the functions; but this is not to be cured by tonics, but by continued and very gradually increased exercise, with light diet, consisting chiefly of vegetables.